Abstract

The epidemiology of tuberculosis in this country is changing because of a combination of biological and social factors. The recent use of DNA fingerprinting of Mycobacterium tuberculosis using restriction-fragment-length polymorphism analysis has suggested that nearly one-third of new cases of tuberculosis being reported in a large metropolitan city is a result of recent infection. The immunosuppression of individuals with the human immunodeficiency virus and the prevalence of multiple drug-resistant tuberculosis has resulted in a renewed interest in the epidemiology and prevention of this disease. To determine the magnitude of the problem in the U.S. Navy enlisted population, a computer search of more than one million inpatient hospitalization records from January 1980 to December 1994 was performed. Total first hospitalization rates for all cases of tuberculosis during this period ranged from 2.2 per 100,000 person-years at risk in white females to 27.5 per 100,000 person-years in males, race "other" (includes mostly Filipinos and Asian-Americans). First hospitalization rates across all cases of tuberculosis declined during this period from a high of 8.7 per 100,000 in 1980 to a low of 2.2 per 100,000 in 1994.

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